Claims Appeals Specialist- Hybrid- Nashville TN - Nashville, TN, US
1 week ago

The Claims Appeals Specialist is responsible for reviewing and processing claims for pre services and post service grievances and appeals requests from customer types (i.e. member, provider, regulatory and third party).+
Responsibilities
- Reviews non-complex grievances and appeals.
- Analyzes the grievance issue(s) to either approve or summarize them within guidelines.
Qualifications
+Previous Claim processing experience is required.+Thorough knowledge of coding structures; as well as COB payments.,Job description
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